Thursday, October 13, 2005

Several days ago, I put up a post about Avian flu. In it, I said that we see a disaster coming, and there is still some time to prepare. In fact, I did a relatively rare thing and praised President Bush for announcing a policy ahead of time. He is willing to use troops if necessary to enforce a quarantine, and that is the right decision in the face of something that could kill as many as 150 million worldwide and millions in the United States.

However, there are two sides to every coin. What Mr. Bush is doing NOW does deserve to be applauded.

On the other hand, it turns out that disease control experts have been warning for years that a pandemic like the one that seems to be brewing right now is inevitable. That the culprit will be some sort of bird flu, and that the question is not if, but when, it will happen.

And, as we recall that in light of similar forecasts from hurricane experts in regard to the precarious position of New Orleans, flood control budgets were slashed to pay for Iraq, tax cuts, and other Bush priorities, we find that it is not only New Orleans flood control that has seen its budgets slashed.

Over the past several years, the Center for Disease Control has seen both budget cuts and diversions of funds from its more general programs to bioterrorism funding. Now, I do agree that in light of 9/11, funding for providing vaccines and training in the event of a bioterror attack using, for example, smallpox or anthrax is necessary, and I am glad this was done. But, the cost has been that we have put other potentially more dangerous sources of disease, including avian flu, on the back burner and turned the flame down.

This year, the administration proposed pretty much the same: According the White House in February, when they released the proposed 2006 budget, funding for Health and Human Services does in fact rise substantially, by $58 billion to $642 billion in fiscal 2006. However, the reason for this is spelled out in the budget, with the new Medicare prescription drug benefit (a sop to pharmaceutical companies if there ever was one) driving up the costs.

The Centers for Disease Control and Prevention, the world's premier public health agency, would be hit the hardest with about $500 million being cut from last year's $4.5 billion budget. CDC would slash preventive health grants and bioterrorism preparedness grants to state and local health departments.

If you do the figuring, $500 million out of $4.5 billion represents an 11% budget cut. And since it is unlikely that they will lay people off, most of that is actually cut from the work that they do. Bioterrorism takes a hit (which makes little sense since the terrorists are still out there) and preventative health. Unfortunately, preventative health includes stockpiling of medications.

Now, two effective antiviral medications are available, which are Tamivir, made by Roche and marketed under the name Tamiflu, and zanamivir, marketed by Glaxo-Wellcome under the name Relenza, both of which, if given within the first few hours of someone experiencing flu symptoms, are 70-90 percent effective.

Unfortunately, while European countries have been stockpiling antiviral medications, the U.S. government has stockpiled enough for 2.3 million people. This is approximately what would be needed for emergency personnel and for the Federal Government (meaning that if there is an outbreak, you can be sure that your Congressman will have access, but there won't be any around in your community.)

Supposedly we plan to acquire another 20 million doses in coming years, but we may not have that much time.

This question needs be asked now, and perhaps we should be demanding that Congress immediately appropriate funds to get more of these drugs because if we wait until the outbreak occurs, it will be too late.

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